Saturday, January 12, 2013

Cocoa and Cognitive Decline

One of the most heartbreaking fields of medicine is that of cognitive decline. I presented to journal club of behavioral neurologists last fall and felt eviscerated… but I know why. There are all these families with loved ones struggling with dementa and hardly any evidenced-based treatments. It's an area rife for fraud and false hopes. Enter cocoa, among other miracle foods (like curcurmin).

I'm not a huge fan of miracle foods. I do see how MCT oil/coconut oil could brush up a ketogenic prescription and help faltering brain energetics. But in general, I'm more a proponant ov avoiding crap processed foods for most meals and enjoying cheats immensely when they come along (like cake for your birthday).

So this paper is all about miracle foods in cocoa flavanols. FLAVANOLS. They decrease peroxidation and blood pressure and increase insulin sensitivty. In other words they are sexy. Way sexy. Let's eat some blueberries and get a photo shoot sexy.

In this study, super high flavanol rich cocoa drinks were administered along with placebo to folks diagnosed with mild cognitive impairment, and the results showed the cocoa flavanoids decreased blood pressure, measures of insulin resistance and cognitive impairment. Working memory, long term memory, and executive functioning all seemed to improve.

From a clinical perspective, I have a hard time poo-pooing the findings. I see little downside from consuming flavanols in the mildly cognitively impaired population considering the likely long-term outcome. But we don't have enough data to make a truly informed choice, which should always make one hesitate.

And, lastly, the study was funded by Mars, Inc, who provided the cocoa drinks for the study…

Like with the coffee and sugar, I wonder about the cocoa and sugar. Did Mars supply them with standard consumer drinks presumably loaded with sugar? If Alzheimer's is a type III diabetes, then any increase in sugar is going to have deleterious effects, right?

Also, that graph of cocoa cons. vs Nobels is about as scientifically interesting as a graph of per cap telephone poles vs Nobels, in my opinion.

Not that I don't suspect it's good stuff. We keep dark chocolate around and I make hot chocolate for my son for breakfast--from raw Dutch cocoa with a smidgen of sugar.

I think it is high in magnesium, copper, and good chocolate is chock full of stearic acid which becomes oleic acid and should have all the heart healthy properties of olive oil. So it's good, nutrient rich food (minus any sugar) that displaces other crap.

My understanding is that the real benefit of olive oil is all the polyphenols that come along with it. I had read somewhere that high oleic sunflower oil - devoid of polyphenols - doesn't seem to have the same benefits.

Also, to get best value from cocoa, it should be raw/unprocessed. Dutch processing (high heat and alkali neutralisation) tends to destroy flavonoids. It also destroys the bitter taste - which is probably the flavonoids!

Do you see any risk in the potential lead toxicity of cocoa? Apparently coooa absorbs lead from the surrounding area, and since much of the worlds cocoa comes from countries that have no regulatiions regarding lead in gasoline, it is believed that cocoa often becomes contaminated during distribution and processing. The effects might be gradual and so would not show up in a short trial.

Interesting. Most studies I've seen link cocoa and dark chocolate consumption with better health overall. But it does bring to mind the brazil nut/radium issue as well (brazil nuts are very high in selenium… and radium!)

This misrepresents the level of study done on flavanols. It is far from one single study funded by Mars. Go to http://www.greenmedinfo.com/greenmed/display/substance/c?sort=desc&order=AC. Look down the list to see just how well researched many natural foodstuffs are. Hopefully I have the link right and you will find cocoa on this list - there are 72 peer reviewed articles on cocoa.

I can see why the results are as they are. I drink french pressed cocoa daily, I suffer from pretty bad ADHD, anxiety, and Tourrettes. I've been drinking it for roughly 2 months now and while mild there is a definite improvement in my tendency to lose my train of thought, and space out a loss less. I find that in class I form better memories of the lectures. Not quite the alertness of coffee, but anxiety doesn't increase.

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About Me

Emily Deans, M.D.: I'm a psychiatrist in Massachusetts searching for evolutionary solutions to the general and mental health problems of the 21st century. Disclaimer: This information is for educational purposes only, and is in no way intended to be personal medical advice. Please ask your physician about any health guidelines seen in this blog, as everyone is different in his or her medical needs.